This is apparent from research by the Institute for Responsible Medicine Use (IVM) and the Trimbos Institute. As part of the ‘Healthy Focus’ project, they investigated – on behalf of the Ministry of Health, Welfare and Sport (VWS) – the extent and motives of improper use of ADHD medication. This mainly concerns methylphenidate, (lis)dexamfetamine and modafinil. During the project, the IVM and Trimbos Institute also looked at the role of care providers and education and prevention professionals.
ADHD medication
In the past year, 4 percent of the students sometimes took ADHD medication improperly, ie without a doctor’s prescription. This mainly concerns (bachelor) students between the ages of 22 and 25. This is evident from the recently published ‘Monitor Mental Health and Substance Use Higher Education Students’ of the Trimbos Institute, RIVM and GGD GHOR. During the project, a number of in-depth analyzes were performed on existing datasets. This shows that 5.5 to 22.5 percent of the young adults surveyed ever took ADHD medication without a doctor’s prescription. The misuse of ADHD medication is highest among people who regularly go out.
Students who use ADHD medication improperly expect the drug to improve concentration even without a diagnosis of ADHD. In addition, they expect that they can focus for longer. Students mainly use it around deadlines for assignments, exams and writing the thesis.
Punishable
ADHD medication is only available with a doctor’s prescription in the Netherlands. In addition, methylphenidate and dexamfetamine are also on list I of the Opium Act. This means that wrongfully possessing or trading these substances is punishable by law. In the event of improper use, there is also no careful indication and guidance by a doctor. As a result, there is no control for underlying suffering, such as cardiovascular disease or psychological disorders. Under those circumstances, taking ADHD medications can be risky.
Effects
Side effects include insomnia, nausea, loss of appetite, palpitations and nervousness. During the project, the Trimbos Institute interviewed more than twenty students who used ADHD medication improperly. Some of them also suffered from these side effects. In addition, improper use can also lead to psychological dependence. Students then think that they can no longer learn without the use of ADHD medication.
Provide Carefully
Students indicate that they often receive ADHD medication from acquaintances, friends and family, who are prescribed it on a doctor’s prescription. It appears from conversations with care providers that not all care providers are aware of this improper use. It is therefore important to create awareness among these healthcare providers. In addition, it is necessary to provide ADHD medication carefully. This means: not prescribing if there is no indication, being careful with repeat prescriptions, keeping an eye on what the patient actually uses and preventing the patient from ‘hoarding’ medication. For example, because the patient does not use part of the medication or requests repeat prescriptions, while the medication is no longer needed. It is also important that care providers recognize improper use and discuss the risks involved. Finally, there is a role for employees in education and addiction care in identifying and discussing this use among students.
Project group
With the results of the project, the project group has been able to revise and develop a number of important information materials, such as the fact sheet ‘Inappropriate use of ADHD medication’ and the folder ‘Methylphenidate – info for non-prescription users’† In addition, the results of this project provide insights for further development of materials and interventions to reduce the improper use of ADHD medication. The project group will work on this in the follow-up process.
By: National Education Guide